Choroidal structural changes after phacoemulsification in eyes with age-related macular degeneration

Aim: To evaluate the changes in choroidal vascular structures in patients with dry age-related macular degeneration (AMD) and healthy controls (No-AMD) after phacoemulsification. Methods: This prospective study was conducted in 34 eyes of 19 patients in the AMD group and 32 eyes of 20 patients in the no-AMD group who had uneventful phacoemulsification. Best-corrected visual acuity, slit-lamp biomicroscopy, and intraocular pressure were recorded. Choroidal thickness (CT) measurements of the subjects were obtained using enhanced depth imaging optical coherence tomography (Edi-OCT) (RS-3000 Advance, Nidek, Japan), and choroidal vascular index (CVI) was calculated by using the binarization method at baseline and postoperatively at months 1 (M1) and 3 (M3) and the results were compared. Results: There was no significant difference between the patients in terms of age and gender (p=0.069, p=0.855 respectively). The mean CVI at baseline was 0.644 ± 0.019% in the AMD group and 0.657 ± 0.021% in the no-AMD group (p=0.025). In the AMD group, the CVI increased significantly in M3 compared to preoperative values (p=0.001). There was no significant difference between the two groups in terms of CT in baseline, M1, and M3 (p>0.05). There was a significant increase in CT in M1 compared to preoperative values in both groups (p=0.026 and p=0.050, respectively). Conclusion: Although the preoperative CVI was lower in the AMD group than in the no-AMD group, there was a greater increase in CVI after phacoemulsification in the AMD group. While CT values return to normal after phacoemulsification sooner, CVI remains elevated for a longer period

Effect of COVID-19 pandemic on glaucoma

Aim: To observe the course of glaucoma progression after coronavirus disease 2019 (COVID-19) treatment of patients with glaucoma. Methods: This observational case-control study included a total of 74 patients with COVID-19 infection who were diagnosed with glaucoma previously. The study focused on the left eye of 37 patients each was treated as an inpatient (group 1) or outpatient (group 2). Age, gender, existence of systemic and ocular diseases, symptoms, laboratory results, drugs used for COVID-19 and glaucoma, length of hospital stay, intraocular pressure (IOP), and central corneal thickness (CCT) values were recorded. Peripapillary retinal nerve fiber layer thickness (ppRNFLT), ganglion cell–inner plexiform layer complex thickness (GCIPLT), and vertical cup-disc (C-D) ratio results were compared before and after COVID-19 treatment in both groups. Results: A significant increase was observed in IOP and a significant decrease was observed in GCIPLT in both groups (groups 1 and 2 for both values p<0.01 and p=0.02, respectively) after COVID-19 infection. In both groups, the mean difference (MD) for IOP and GCIPLT values were higher in group 1. Although ppRNFLT values decreased in both groups, a significant decrease was observed in group 1 after COVID-19 infection (p=0.03). The mean C-D ratio was higher after COVID-19 infection in groups 1 and 2. (p=0.04 and p=0.051, respectively). CCT did not show a significant difference in either group (p>0.05). Conclusion: PpRNFLT and GCIPLT values were reduced and IOP and C-D ratio values were increased in glaucoma patients after COVID-19 infection. Infection progression was observed to be worse in the inpatient group.

A comparison of two conjunctival rotation autograft techniques in primary pterygium surgery.

PURPOSE: To compare the effects of 90° and 180° conjunctival rotational autograft (CRA) techniques used in primary pterygium surgery. METHODS: Forty-five patients were included in this retrospective study. Visual acuity (VA), corneal topography, and auto-refractometer measurements, as well as detailed biomicroscopic examinations, were performed preoperatively and postoperatively. During surgery, the pterygium tissue was excised then rotated 90° in Group 1 and180° in Group 2, after which it was sutured to the bare sclera. Pterygium recurrence was defined as corneal invasion ≥1 mm. RESULTS: Group 1 consisted of 21 patients with a mean age of 45.1 ± 11.8 years, while Group 2 comprised 24 patients with a mean age of 47.9 ± 13.8 years. The pterygia in Group 1 were graded as more advanced than those in Group 2. A similar number of recurrences were observed in Group 1 (14.3%) and in Group 2 (16.7%). There was no statistically significant difference in terms of the preoperative and postoperative VA and astigmatism values between the two groups. There was a statistically significant improvement in the postoperative VA and astigmatism values in Group 1 and in the postoperative astigmatism values in Group 2. Although postoperative redness was more common in Group 1, no statistically significant difference was found between the groups. CONCLUSION: BothCRA techniques can be successful in patients for whom it is desirable to avoid a conjunctival autograft and for patients without high cosmetic expectations

Eye Involvement as the Initial Sign of Multiple Sclerosis in a Case with Familial Mediterranean Fever

Familial Mediterranean fever (FMF) is a common hereditary auto-inflammatory disease characterized by recurrent and selflimited attacks of serosal inflammation. The disease demonstrates an autosomal recessive inheritance pattern. Serositis can be observed as abdominal pain (peritonitis), chest pain (pleuritis) and joint pain (arthritis) usually accompanied by fever. The disease is more prevalent among the people living in the Middle East and Mediterranean regions. The prevalence ranges from 1/250 to 1/1000 depending upon the geographic locations [1]. Reports of ophthalmological manifestations in FMF are few and include retinal changes, panuveitis, anterior uveitis, scleritis, and episcleritis [2]. Multiple Sclerosis (MS) is a disease of the central nervous system characterized by multiple areas of inflammation and demyelination in the white matter of the brain and spinal cord [3]. Common neuro-ophthalmologic manifestation of MS is unilateral and painful vision loss due to optic neuritis. This is the first manifestation of MS, and usually appears as single-sided retrobulbar optic neuritis. Ocular motor deficits in multiple sclerosis include inter nuclear ophthalmoplegia (INO) and nystagmus, resulting in diplopia, oscillopsia, blurred vision, loss of stereopsis, and reading fatigue [3].</p

DETERMINING THE RELATIONSHIP BETWEEN HEALTH TECHNICIAN STUDENTS’ ATTITUDES TO THE COVID-19 PANDEMIC AND INTOLERANCE OF UNCERTAINTY WITH DEPRESSION, ANXIETY, AND STRESS LEVELS

Background: This study aimed to identify the relationship between the attitudes of health technician students towards COVID-19 and their intolerance to uncertainty with depression, anxiety, and stress. Subjects and methods: This cross-sectional study was conducted with health technician students at two public universities in western Turkey. Data were collected from January 29 to April 5, 2021. In this study, The Descriptive Data Form; Depression, Anxiety and Stress Scale-21; The Health Education Students’ Attitude Scale towards the COVID-19 outbreak, and the Intolerance of Uncertainty Scale-12 were used. The electronic versions of the questionnaires were shared with students in WhatsApp groups. Results: A total of 1132 students participated in the study and 23.2% of the students had mild, 21.6% moderate, and 2.8% severe depression. Additionally, 9.4% of the students had mild, 16.3% moderate, and 5.1% severe anxiety. Furthermore, 12.5% of the participants had mild and 5.5% had moderate stress. Smoking, prospective and inhibitory anxiety, negative perception of the state’s efforts to prevent the outbreak, anxiety about the virus, and belief of intentional spread significantly affected depression, anxiety, and stress levels (p&lt;0.05). Furthermore, the place of residence and the presence of acquaintances infected with COVID-19 significantly affected anxiety levels (p&lt;0.05). Conclusions: It may be beneficial to develop online psychoeducation and psychotherapy programs and to direct young people to these platforms during the social isolation process of COVID-19. Training in virus protection is also strongly recommended.</p

The Efficacy and Safety of Intravitreal Dexamethasone Implant for the Treatment of Macular Edema Related to Retinal Vein Occlusion: Real-life Data and Prognostic Factors in a Turkish Population

Objectives: To evaluate the efficacy and safety of dexamethasone (DEX) implants as mono or combination therapy for macular edema in retinal vein occlusion (RVO) with real-life conditions, and to detect factors that influence final visual acuity. Materials and Methods: Twenty-five eyes with macular edema secondary to RVO underwent assessments for central macular thickness (CMT), best-corrected visual acuity (BCVA), adverse events, and also morphologic changes in optical coherence tomography at an interval of 4-8 weeks after at least one DEX implant. Results: Seventeen eyes with branch RVO and 8 eyes with central RVO were eligible for the study. The mean follow-up duration was 17 months (range, 12-26 months). Both mean BCVA (p=0.009) and CMT (p=0.006) improved significantly, and visual gains of ≥3 lines were achieved in 32% and ≥2 lines in 52% at the end of the follow-up period. The most powerful individual predictor of final visual acuity was baseline BCVA (r2=0.611, p<0.001, stepwise multiple regression), but the most efficient model was the combination of the ellipsoid zone (EZ) integrity and baseline BCVA (r2=0.766, p<0.001, stepwise multiple regression). Complication rates were very low after repeated DEX implants. Conclusion: DEX implant seems to be an effective and safe treatment for macular edema in RVO despite negative real-life factors, and visual outcomes are associated with baseline visual acuity and EZ integrity